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GERACARE: The Trans-disciplinary approach to optimise quality of life

One would often hear that people say: “I do not want to get that old” or that “I would rather die than to set foot in an old age home”. The motivation behind this reasoning is almost never questioned, while rightfully it should be challenged. It all boils down to one factor alone…quality of life. If one can continue living life to the fullest AND in the way that one is used to until the end, the fear of ageing and the stigmatisation thereof would be suppressed.

At GERATEC we strive to optimise quality of life for our residents. We do so by focusing our model of caring on counteracting the so-called Geriatric Giants. The five Geriatric Giants are well known and scientifically defined as those factors that cause the biggest decline in the functionality of the ageing person. It is therefore not surprising at all that they can be defined as the following:

Impaired homeostasis
Also defined as homeostatic imbalances and pertains to a disturbance in the body’s biochemical balance. It is a cause for great concern as it directly influences the physiology (functioning) of the body. Two examples of homeostatic imbalances which impact directly on quality of life are uncontrolled blood glucose levels and dehydration. Uncontrolled blood glucose levels are very common as the most people do not consume a low GI carbohydrate rich food every three hours. It has a huge impact on various organ systems in the body, especially the brain. Many neurological and mental conditions can be relieved to a certain degree by the regulation of blood glucose levels. Research has indicated that uncontrolled levels worsen symptoms of anxiety, depression and aggression. Therefore an adjustment to the normal meal plan by adding snacks three hourly is worthwhile. Dehydration is a common phenomenon in the elders and has a detrimental effect on all cells in the body. It might even mimic the symptoms of dementia, while instead it is only confusion caused by an impaired fluid balance. This brings us to the next Geriatric Giant, namely confusion.

Confusion
This symptom is very often mistaken for dementia and might be caused by a number of factors including dehydration, adverse drug reactions, micro nutrient deficiencies and bladder infection. It is therefore of the utmost importance to always find the cause of the symptom and not to self diagnose or assume that all mental stress is related to dementia.

Falls
Together with incontinence, falls are one of the strongest motivators for somebody to move or be moved (by family) into a care centre. As with the other Geriatric Giants, it can have a noticeable effect on one’s quality of life and even the fear of falling might impact negatively on one’s daily activities. Once again the risk for falling can be reduced if one is aware of the potential dangers that pose a risk for each individual. These can be identified and assessed by a standardised measuring tool, after which intervention can take place to make the environment safer to the individual.

Incontinence
It is for sure one of the Geriatric Giants which is the most poorly understood and managed in care centres. Incontinence is wrongly believed to be a normal part of ageing especially in the female population. Another myth which worsens the situation is the general idea that it is irreversible. The person classified as incontinent is also stigmatised by the disrespectful terms used to refer to incontinence ware such as nappies and diapers. Therefore although this Geriatric Giant is one that most people are ashamed of and would not openly talk about, it is one of the risk factors that can be practically addressed and rectified.

Iatrogenic disorders
As health care professionals we all mean well when we treat a patient. The problem comes in with the words: “treat” and “patient”, because elders living in a care setting are not patients who need to be treated, they are individuals who might need some support to optimise living. Iatrogenic disorders pertain to those medical interventions that we as health care personnel inflict with the purest intentions, but which at the end might cause more harm than good. A good example is that of polypharmacy where one is given too many types of medications and drugs which interact with one another and cause one to experience adverse effects. Many times drowsiness, confusion and mood swings can be due to medication which is administered wrongly.

The abovementioned factors have a direct influence on quality of life, but are most certainly not a normal part of ageing as they are sometimes wrongly viewed. By being aware of them, assessing the situation and intervening through the implementation of a Resident Directed Support Plan, one can successfully diminish their impact on the resident’s everyday living. That is also where the GERATEC care team presents themselves:

Our care team follows a trans-disciplinary approach. It is a step further than the well advocated multi disciplinary approach where various health care professionals combine their approach to focus treatment more holistically. Our care team (consisting out of registered nursing professionals, occupational therapists and dieticians) join their expertise but also teach one another skills and theory to fulfil each other’s role if the need arises.

By following the trans-disciplinary approach our team recognises every individual resident’s uniqueness. We make use of scientifically based, standardised measuring tools to identify the risk factors which may impact on quality of life. The assessment outcomes are then used as baseline for the compilation of the Resident Directed Support Plan which describes the overall support of the particular resident.
In conclusion by following a Resident Directed Approach aimed to fulfil in both the Domains of Wellness and Wellbeing for every resident, we strive to optimise quality of life.

Over the course of the next year we as the GERATEC Care Team would love to share some of our knowledge and practical experience with you by monthly posting an interesting article on the website. We are going to start by looking at the Geriatric Giants in detail, followed by articles which focus on ideas to counteract the effects of the Giants. We would also welcome your input on the articles. If you therefore feel that you would like to comment on the article, part take in a discussion or have any questions, please do so via Facebook or by email.